Anatomy of the Tongue
The tongue is a muscular organ found in the mouth of many vertebrates. It helps to chew and swallow food, in articulation and oral cleansing.
The anatomy of the tongue is as follows-
The human tongue is divided into two parts namely-
- The oral part (the part visible in the mouth/oral cavity)
- The base of the tongue (at the back)
The tongue can be subdivided into tip, body and base.
The dorsal (upper) surface of the body is divided into two symmetrical halves by the median sulcus. At the end of this sulcus is the foramen cecum. A normal healthy tongue is pink colored, and its surface is covered with tiny nodules termed papillae which give the tongue its characteristic texture.
The four types of papillae are
- Filiform papillae
- Fungiform papillae
- Foliate papillae
- Vallate papillae
All papillae except the filiform type have taste buds which contain nerve endings for taste sensation.
Muscles - The muscles of the tongue include:
- Inferior and Superior Longitudinal muscle
- Transverse Muscle
- Vertical Muscle
The nerve supply of the tongue consists of the lingual nerve, chorda tympani, glossopharyngeal nerve and the internal laryngeal nerve. The blood supply of the tongue is mainly through the lingual artery.
The tongue undergoes numerous changes during health and disease and can give a clue to many underlying conditions. The various changes in the tongue include the following.
a) White tongue - A spot or white coating on your tongue can indicate:
Oral Thrush- Also known as oral candidiasis, is a yeast infection that occurs inside the mouth. It is observed as white patches that are mainly of cottage cheese consistency.
It is mostly seen in infants, elderly people who wear dentures or in individuals with poor immunity.
Treatment includes topical anti-fungal drugs, treating the underlying cause, oral hygiene regular cleaning of dentures and removing them before going to bed.
Leukoplakia- It occurs due to an excessive growth of cells in the mouth which results in white patches on the tongue and on the oral mucus membrane.
Leukoplakia is a precancerous condition, and can lead to oral cancer.
Treatment includes surgical removal of the white patch, quitting smoking and alcohol, taking care of dental irritants such as improper dentures and fillings, sharp teeth and taking prescribed medicines on time.
Oral Lichen planus- They are white lines on the tongue and appear lace-like. They can cause discomfort, pain and irritation. There is no cure; treatment includes symptomatic management of pain and irritation.
b)Red Tongue- A red colored tongue might indicate-
- Vitamin deficiency- Vitamin B-12 and folic acid deficiencies
- Geographic tongue - Irregular, reddish patches appear on the tongue surface giving a map-like appearance. These irregular patches usually have a white border and their location on the tongue surface can change from day to day. This condition is harmless; however antihistamine gel and steroid mouthwashes can reduce this discomfort.
- Scarlet fever- It is an infection that produces a strawberry-like (bumpy and red) appearance of the tongue. It is treated with antibiotics.
- Kawasaki disease - This disease causes strawberry-like appearance on the tongue surface. It is usually observed in children below 5 years and is accompanied with high fever. Kawasaki disease is a serious illness and needs immediate medical attention.
c) Black or Brown tongue- The tongue appears black, brown or yellow in color. A black colored tongue may result from an overgrowth of tongue papillae leading to numerous bacteria on the tongue surface, making it appear black or brown.
It is a harmless condition and usually subsides without any medical attention. Along with a black tongue, other symptoms can also exist, such as fuzzy or hairy appearance of tongue, bad breath and altered taste sensation.
Treatment includes removal of any underlying cause and maintaining a good oral hygiene.
d)Purple or Blue Tongue- Certain illnesses can produce a purple or red-purple tongue and it is a possibility that a purple tongue may later change to a blue color. A purple tongue is very uncommon and appears in some nutritional deficiencies only such as in vitamin B12 (riboflavin) deficiency.
A blue tongue is a sign of cyanosis which occurs when oxygen content of blood is very low.
a) Wrinkles on the tongue- It is also referred to as ‘fissured’ tongue or ‘scrotal’ tongue.
It is a harmless benign condition with one or more shallow or deep fissures and grooves on the tongue surface.
As it is a benign condition it does not require any particular treatment, but patients should be advised to clean their tongue surface regularly and maintain a good oral hygiene.
b) Small white patches- It is a thickened area in the lining of the mouth and has a white appearance, also known as leukoplakia.
It can develop due to fungal infection, trauma, friction and chemical irritants.
Treatment includes eliminating the underlying cause and anti-fungal medications.
c)Reddish lesions- It can be denoted as erythroplakia (any oral mucosal lesion that appears as a bright red velvety plaques and which cannot be distinguished as any other recognizable condition).
It has many causes; therefore for accurate diagnosis investigations needs to be done, including a biopsy to rule out oral cancer.
d)Burning sensation- A burning sensation on the tongue may be due to burning mouth syndrome. Its symptoms include altered taste and dry mouth resulting in increased thirst.
The causes of burning mouth syndrome are dry mouth, allergies, nutritional deficiencies, dentures, fungal infections, few oral drugs; mouth irritation, gastro-esophageal reflux disease or it can be idiopathic also.
Treatment includes identifying the root cause of this problem. For the treatment procedure it is advisable that you consult your doctor.
e)Hills and Valleys-
It is also known as geographic tongue and appears like a bumpy terrain. It is an inflammation of the tongue surface and is benign.
It requires no treatment, but in case of burning sensation your doctor can prescribe you anti-inflammatory and antihistaminic medicines.
Canker sores or mouth ulcers are common painful ulcers. They occur mostly due to local trauma (ill-fitting dentures, sharp teeth) and aphthous stomatitis (recurrent round or oval ulcers inside the mouth).
Treatment includes identifying the underlying cause, following good oral hygiene, antiseptic mouthwashes and topical analgesics.
It is a good habit to keep your mouth and teeth in a perfect condition. This includes removal of dental plaque and tartar which are responsible for many dental problems like tooth decay, gum disease and bad breath. Poor dental health may affect general health and lead to other serious diseases like heart attack, angina and endocarditis. Oral hygiene includes the following practices-
- Teeth brushing twice a day
- Flossing - cleaning between teeth
- Removal of plaque
- Using fluoride mouth-rinses
- Limiting sugary foods and drinks
- Eating a balanced diet and avoiding snacks in-between meals
- Using dental sealants for children
- Regular dental check-ups
- Avoid smoking
- Tongue - (https://en.wikipedia.org/wiki/Tongue)
- What Your Tongue Can Tell You About Your Health - (https://health.clevelandclinic.org/2015/04/what-your-tongue-can-tell-you-about-your-health/)
- Fissured tongue - (http://www.dermnetnz.org/site-age-specific/fissured-tongue.html)
- Erythroplakia - (https://en.wikipedia.org/wiki/Erythroplakia)
- Burning mouth syndrome - (http://www.mayoclinic.org/diseases-conditions/burning-mouth-syndrome/symptoms-causes/dxc-20179960)
- Mouth ulcer - (https://en.wikipedia.org/wiki/Mouth_ulcer)
Latest Publications and Research on Learn What Your Tongue Says About Your General Health
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